Alaska Medicare Plans

Coverage and Benefits

If you live in the state of Alaska and you’re over the age of 65, you have the opportunity to enroll in the Alaska medicare plans offered by the federal government. Traditional Medicare, which consists of Medicare Parts A and B, is the base of all Medicare plans in Alaska. For many people, Traditional Medicare is fairly comprehensive, but gaps in coverage still exist. And if you aren’t careful, these gaps could lead to expensive medical bills later on. The good news, though, is that coverage options exist which can help cover these “gaps” and protect you financially. We’ll go into more detail about those options here.

All it takes is 40 quarters of employment history (a minimum of 10 years) for free enrollment in Medicare Part A. If you have less than 10 years of employment history, you will likely have to pay a premium for Part A. Additionally, Part B comes with its own premium costs no matter what your employment history is. These costs are mandatory. Your local Social Security Office can supply you with more specifics on premium costs for Traditional Medicare.

Medicare Part A (Hospital Coverage)

Inpatient care in hospitals

Skilled nursing facility care

Hospice care

Home health care

Medicare Part B (Medical Insurance)

Services from doctors and health providers

Outpatient care

Home health care

Durable medical equipment

Some preventive services

Medicare Part C (Medicare Advantage)

Includes all benefits and services covered under Part A and Part B

Usually includes Medicare prescription drug coverage (Part D) as part of the plan

Run by Medicare-approved private insurance companies

May include extra benefits and services for an extra cost

Medicare Part D (Drug Coverage)

Helps cover the cost of prescription drugs

Run by Medicare-approved private insurance companies

May help lower your prescription drug costs and help protect against higher costs in the future

Medicare Insurance Programs in Alaska

Medicare beneficiaries have a significant presence in Alaska. There are a total of 69,301 enrollees in the state. Surprisingly, Alaska differs from the rest of the country in that 0% of Medicare beneficiaries are enrolled in an Advantage (otherwise known as Medicare Part C) program. 11.4% of those enrolled in Medicare are taking advantage of Medigap supplemental insurance. Beyond that, the remaining 88.6% of Alaskans may be supplementing their health care needs with a private insurance plan, benefits offered through their employer, or relying upon Medicare Parts A and B only and leaving themselves vulnerable to costly medical bills.

Of course, this does not apply to anyone who isn’t already enrolled or in the process of enrolling in Medicare. Click here for more information on Medicare enrollment.

How Come So Many People in Alaska Purchase Coverage Beyond Original Medicare?

Purchasing additional medical coverage beyond Traditional Medicare is the best way to protect yourself during your golden years from unexpected health care expenses. Medicare Part A and Medicare Part B cover most of what retired individuals need, medically speaking. Unfortunately, there are still holes in Medicare coverage that could leave you with some big bills if you aren’t protected. For examples, consult this helpful table:

Medicare Part A Costs

Medicare Part B Costs

$1,184 (as of 2014) Part A Annual Deductible for access to Basic Hospital Services

Obtaining supplemental health coverage could save you thousands in medical bills down the road. For a truly trustworthy and comprehensive plan, review the coverage options we’ve outlined below. The information can be invaluable for helping you make important decisions regarding your health care needs.

Coverage Option #1: Alaska Medicare Supplement Plans

Most Medicare supplement policies are labeled as “Medigap” policies. If you have a Medicare supplement policy, you can be shielded from unexpected medical expenses incurred from the gaps in Medicare. Right now, there are 10 federally endorsed supplement plans available to the public. Plans A-D, F, G, and K-N are still in effect, but plans E, H, I and J have been weeded out due to the Medicare Modernization Act of 2010. All 10 of the active plans provide for equal forms of coverage, regardless of your state or insurance company. Costs will vary, so make sure you shop around for the best deal.

Below is a detailed explanation of what each plan covers in detail:

Plans

A

B

C

D

F

G

K

L

M

N

Part A Hospital Coinsurance

✓

✓

✓

✓

✓

✓

✓

✓

✓

✓

Hospital Reserve Days

✓

✓

✓

✓

✓

✓

✓

✓

✓

✓

Benefit For Blood

✓

✓

✓

✓

✓

✓

50%

75%

✓

✓

Part B Coinsurance

✓

✓

✓

✓

✓

✓

50%

75%

✓

*Co-Pays

Hospice Coinsurance

✓

✓

✓

✓

✓

✓

50%

75%

✓

✓

Skilled Nursing Facility

✖

✖

✓

✓

✓

✓

50%

75%

✓

✓

Part A Deductible

✖

✓

✓

✓

✓

✓

50%

75%

50%

✓

Part B Deductible

✖

✖

✓

✖

✓

✖

✖

✖

✖

✖

Part B Excess Charges

✖

✖

✖

✖

✓

✓

✖

✖

✖

✖

Foreign Travel Benefit

✖

✖

✓

✓

✓

✓

✖

✓

✓

✓

Preventive Care Coinsurance

✓

✓

✓

✓

✓

✓

✓

✓

✓

✓

Out of Pocket Limit

None

None

None

None

None

None

$4,620

$2,310

None

None

Co-Pays are $20 per office visit, and $50 per ER visit if not admitted to a hospital.** A checkmark indicates 100% coverage for the specified benefit.

Coverage Option #2: Alaska Medicare Advantage Plans

You can also replace Medicare Parts A and B with Medicare Part C, a.k.a. Medicare Advantage (MA). If you leave Traditional Medicare for Medicare Part C, your health care will become the responsibility of whatever private health insurance company you choose. The federal government will no longer foot the bill for your medical costs. Despite this, you will still be eligible for medical benefits as outlined by Original Medicare. You might even have additional benefits depending on what plan you sign up with. This is because all Medicare Advantage policies are legally mandated to offer equal or better coverage options than what the government does.

In order to attract customers, many MA plans offer these extra benefits, including dental, vision, and prescription drugs, just to name a few. On the one hand, having all of your medical benefits under one plan is very convenient. Unfortunately, many Medicare Advantage plans come with costly monthly premiums, and highly restrictive networks. If you’re considering Medicare Advantage, make sure you read all of the fine print, and that the plan will offer you the medical benefits that you need to stay healthy.

For those who are unsure, Health Maintenance Organizations (HMOs) and Preferred Provider Organizations are the selective networks of doctors and facilities from which Medicare Advantage members can seek medical treatment. Take a look at HMO and PPO networks in your area:

To clear up some confusion, read the following table carefully. It easily compares the important differences between Medicare Advantage and Medigap:

Questions

Medicare Advantage

Medicare Supplement

How are the plans funded?

Medicare will pay your insurance company a fixed amount based on average healthcare costs for your region. You may also be required to pay a premium based on your location and insurance company.

Your monthly premium takes care of the majority of your expenses.

Do I continue paying for Part B?

Yes

Yes

What does it cost me?

Some plans offer a zero-dollar premium (because the government subsidy covers the full cost). Other plans may cost up to 0-0 monthly.

While each plan does require a monthly premium, many of them are affordably priced.

What does the plan cover?

Depending on your plan, it will cover at least the same benefits offered by Medicare parts A & B. Possibly other benefits; but the more benefits you sign up for, the higher your out-of-pocket expenses may be.

All eligible expenses are split between Medicare, and your Medicare Supplement plan. If you have a comprehensive plan, such as Plan F, 100% of eligible expenses not covered by Medicare will be covered by your supplement insurance.

Can I budget my health care expenses?

It’s challenging; the more often you require medical care, the more often you may be required to pay out-of-pocket.

Budgeting is much easier with a Medicare supplement. You have fewer out-of-pocket expenses, and one simple monthly premium.

Can my plan be cancelled?

Yes. Unfortunately, your health insurance company has the legal right to review their Medicare Advantage services annually and decide whether or not they wish to continue providing coverage.

No – not unless you fail to pay your monthly premium, or your insurance company goes bankrupt. Only under such extenuating circumstances could your plan be cancelled.

Are pre-approvals or pre-certifications required?

Unfortunately, yes. These Plans usually require pre-certification or other qualification for some specific types of care.

No pre-approvals are required. If you qualify for Medicare, you will qualify for a Medicare supplement plan.

Can I use any doctor or hospital?

Usually, you choose from a network of pre-approved providers. These networks can fluctuate over time.

Yes. You are free to choose any doctor and/or hospital in the U.S. which accepts Medicare.

Can drug, vision, or dental coverage be included in the policy?

Yes.

No. These forms of coverage must be purchased separately.

Who is this plan type generally best suited for?

If you are relatively young, healthy, live in an urban area, and have a limited income, a Medicare Advantage plan could work for you.

If you live in a rural area without easy access to provider networks, if you like to budget your finances, or if you want comprehensive coverage, you might prefer a Medicare supplement plan.

Additional Alaska Medicare Resources

It’s likely that you still have some questions. Take a look at the number directory below. These contact numbers will put you in touch with local offices and Medicare supplement insurance experts who can give you the information you need in order to make the best decisions regarding your healthcare.

Important Medicare Terms for Alaska Residents

HMO: Health Maintenance Organization, this refers to a network of doctors and hospitals with a plans’ network.

PPO: Preferred Provider Organization, this refers to a network of doctors and hospitals with a plans’ network.

Co-Pay: Amount of money charged per visit to doctor, specialist, etc.

Co-Insurance: A percentage required by the policyholder to pay out-of-pocket. For example, 80/20 coinsurance means the insurance company will cover 80% of the charges, and the policyholder pays the remaining 20% of the charges.

Deductible: This is the amount of money required out-of-pocket by the policyholder before the insurance will kick-in and pay for any remaining charges. For example, a policy with a $1,000 deductible means that you must pay full healthcare costs out-of-pocket up to $1,000 before the plan will start coverage.